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Comment by bsimpson | Hacker News Reader

Gets manipulated in the other direction too: financial incentives nudge hospitals to assign coronavirus as a cause of death if you had it when you died, even if it wasn't what actually killed you. I don't know if it's as blatant as "died in a car crash of coronavirus," but enough of my medical friends have mentioned it that I believe there's truth to it.

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Another financial incentive that exists: Families can get up to $9,000 for funeral expenses if the cause of death is listed as Covid.

https://www.cnet.com/personal-finance/covid-funeral-reimburs...

Why would that incentivize the hospital though? Isn’t that who determines cause of death?

Lady calls in, her 450lb 57 year old son with uncontrolled type 2 diabetes and COPD is found dead at his home. Post-mortem test shows he's positive for COVID. You're the doctor, your hospital has had to furlough a quarter of their staff because nobody is coming in for any outpatient care, there's an ICU full of people on vents and you've been there for 18 hours already.

The guys mom is there and you're working up her son's case. You have to fill in the blank for cause of death. What are you going to do? Order an autopsy and possibly cut this family out of government aid for COVID-related expenses and deaths?

Not necessarily the hospital itself, but with that kind of incentive it's going to find its way in. One possibility is family members applying pressure to compassionate doctors.

“Show me the incentive and I'll show you the outcome” - Charlie Munger

Fantastic quote!

There's at least one example of that I'm aware of:

https://www.fox35orlando.com/news/fox-35-investigates-questi...

It's pretty difficult to prove covid was not a contributing factor to a person's death. So unless there's clear evidence it wasn't, it should be listed as a contributing factor.

This isn't really any different than when a person dies some immediate event while also suffering from an underlying illness. If a leukemia patent suffers a an aneurysm, one would expect leukemia to be present on their death certificate.

"It is pretty difficult to prove god does not exist, so unless there's clear evidence he doesn't, it should be assumed he does."

The answer is the opposite, actually: if it is difficult to disprove any single contributor one way or another it should not be listed as a contributing factor.

> financial incentives nudge hospitals to assign coronavirus as a cause of death if you had it when you died, even if it wasn't what actually killed you.

This accusation of fraud and malpractice has been a common talking point amongst those seeking to downplay COVID.

But I've yet to see any evidence that its common or widespread.

Many tallies in the US were adjusted after this specific criticism over 8 months ago. But I guess the talking point won't be updated, oh well.

My main issue with this criticism is that tallies of other illnesses have the same issues. So if an actual flu season said 20,000 people died, it had the same reporting issues and distribution of reporting issues.

This means a direct comparison to two ailments with the same distribution of reporting issues gives you an accurate view of the affect.

So even without going back and fixing the records - which I'm not sure you or other people even know happened - this means Covid deaths are more accurate and actually proves how it is much much worse.

Anybody see the irony there? Given that the point of bringing attention to this would be to downplay the severity or response (or that there is a 100% correlation between the people that subscribe to these talking points and want a dramatically different response or no mitigation response at all), so, thanks for keeping healthcare authorities accountable, I guess.

Isn't it plausible your medical friends mentioned it a lot because...others around them also mentioned it a lot? Doctors and nurses are just as capable as spreading rumors as anyone else.

Since when are hospitals paid for having their patients die a specific way?

Medicare pays 20% more if they say that a patient has COVID[1].

[1] https://www.politifact.com/factchecks/2020/apr/21/facebook-p...

> Our ruling > A post shared on Facebook claims hospitals have a financial incentive to claim patients had COVID-19, saying payment is three times higher if a patient goes on a ventilator. An article the post links to includes comments from a doctor who suggests the number of coronavirus cases is being padded.

> It is standard for Medicare to pay roughly three times more for a patient with a respiratory condition who goes on a ventilator than for one who does not. That has nothing to do with the coronavirus.

> As part of a federal stimulus bill, Medicare is paying hospitals 20% more than standard rates for COVID-19 patients.

> Indications are that due to a lack of testing and other factors, the number of coronavirus cases has been undercounted, not padded.

> For a statement that is partially accurate, our rating is Half True.

Something to do with Medicare or maybe Medicaid.

Since the way you died affects how insurance pays out compensations.

Source? Hospitals bill based on services performed, not based on what the ailment is. Nowhere in my bills did it say I went in for a kidney stone last year.

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